CBT for Depression
Everyone feels sad or down from time to time. But sometimes those feelings become intense enough to affect our relationships, our work, or everyday routines like eating and sleeping. When that happens, it may be a sign of something more — depression.
Depression doesn't discriminate. No matter who you are or what your life looks like, you're vulnerable to it, and it's the most common mental health diagnosis worldwide (Reichenberg & Seligman, 2016). The good news is that there are a number of evidence-based treatments that can help. This article covers what depression is, how it's treated, and how to get started if you think treatment might be right for you.
What Is Depression?
Depression is common, and it's the most frequently recurring mental health diagnosis (Moloud et al., 2022). While it can develop at any age, it's most often diagnosed in people in their 20s, and within any given year, up to 7% of people in the U.S. will experience it (American Psychiatric Association [APA], 2022).
Depression is marked by ongoing sadness, hopelessness, and/or a loss of interest or pleasure in most activities, lasting at least two weeks and present for most of the day (APA, 2022). Other symptoms can include:
• Sleeping too much or too little
• Unintended weight loss or gain
• A noticeable increase or decrease in physical movement
• Low energy or fatigue
• Feelings of worthlessness or guilt
• Trouble concentrating or making decisions
• Recurring thoughts of death or suicide
(APA, 2022)
Depression causes significant difficulty functioning at work, in relationships, or in other important areas of life. For some people, simply getting through the day takes noticeably more effort — even if that effort isn't visible to others. Depression can also show up in different patterns: some people experience it over long stretches of time, while others have it come and go in distinct episodes (APA, 2022).
Can Depression Be Treated?
Yes. Treatment depends on several factors, including a person's age, the number and severity of symptoms, and any other physical or mental health conditions they may have (Reichenberg & Seligman, 2016). Fortunately, depression treatment has been extensively researched, and there are many effective options — most involve some form of talk therapy, sometimes paired with medication.
Among talk therapies, Cognitive Behavioral Therapy (CBT) is the most well-researched treatment for depression in adults and is considered highly effective (Cuijpers et al., 2013). It's also an effective option for children and adolescents (Reichenberg & Seligman, 2016). CBT for depression can be delivered one-on-one, in a group setting, or through a combination of both — and research supports its effectiveness in either format (Bryde Christensen et al., 2021; Feng et al., 2012).
What Is CBT?
Cognitive Behavioral Therapy (CBT) is a form of talk therapy that draws on both cognitive and behavioral approaches. While many clinicians contributed to its development, Dr. Albert Ellis is generally credited as its founder (DiGiuseppe et al., 2014). CBT is typically time-limited, focused on solving present-day problems rather than dwelling on the past, and backed by research supporting its effectiveness across a wide range of mental health conditions.
CBT is built on the idea that our thoughts, feelings, and behaviors are all connected and influence one another. It's not necessarily the events in our lives — whether internal, like a thought, or external, like something that happens to us — but rather how we interpret those events that shapes how we feel and respond. Because these three areas are so interconnected, working on one (like unhelpful thought patterns) tends to create positive shifts in the others.
Everyone is susceptible to unhelpful patterns of thinking, which can lead to behaviors that work against us and to negative views of ourselves, the future, or the world. In CBT, the client and therapist collaboratively set goals — often focused on building skills to manage difficult emotions and urges, as well as shifting unhelpful thinking patterns so the client can navigate life's challenges more effectively. Therapists tailor their approach to each client and often assign homework between sessions to reinforce new skills.
How Does Group Therapy Differ From Individual Therapy?
In both individual and group therapy, clients work with a therapist to address whatever feels most pressing. In individual therapy, the relationship between client and therapist is a key factor in treatment success — research suggests it may be the single most important ingredient in outcomes (Bryde Christensen et al., 2021).
That relationship still matters in group therapy, but the connections between group members become important too. A sense of group cohesion — feeling committed to, respected by, and connected with other group members — has been linked to better treatment outcomes (Bryde Christensen et al., 2021). Group CBT also offers benefits individual therapy doesn't: seeing peers model helpful coping strategies, mutual support, and a sense of accountability to others in the group (Bryde Christensen et al., 2021). Structurally, individual and group CBT sessions look fairly similar, often including a session agenda, a homework review, and skill-building exercises.
How Do I Know if Group CBT Is Right for Me?
If you're weighing individual versus group therapy, a good first step is connecting with a therapist who practices CBT. They can help you figure out which format best fits your needs and goals, and work with you to build a treatment plan designed around your specific situation.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Bryde Christensen, A., Wahrén, S., Reinholt, N., Poulsen, S., Hvenegaard, M., Simonsen, E., & Arnfred, S. (2021). "Despite the differences, we were all the same": Group cohesion in diagnosis-specific and transdiagnostic CBT groups for anxiety and depression: A qualitative study. International Journal of Environmental Research and Public Health, 18(10), 5324. https://doi.org/10.3390/ijerph18105324
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58(7), 376–385. https://doi.org/10.1177/070674371305800702
DiGiuseppe, R. A., Doyle, K. A., Dryden, W., & Backx, W. (2014). A practitioner's guide to rational emotive behavior therapy (3rd ed.). Oxford University Press.
Feng, C. Y., Chu, H., Chen, C. H., Chang, Y. S., Chen, T. H., Chou, Y. H., Chang, Y. C., & Chou, K. R. (2012). The effect of cognitive behavioral group therapy for depression: A meta-analysis 2000–2010. Worldviews on Evidence-Based Nursing, 9(1), 2–17. https://doi.org/10.1111/j.1741-6787.2011.00229.x
Moloud, R., Saeed, Y., & Mahmonir, H. (2022). Cognitive-behavioral group therapy in major depressive disorder with focus on self-esteem and optimism: An interventional study. BMC Psychiatry, 22(299). https://doi.org/10.1186/s12888-022-03918-y
Reichenberg, L. W., & Seligman, L. (2016). Selecting effective treatments: A comprehensive, systemic guide to treating mental disorders. Wiley.